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Flu Shots - Flu Shot Recommendations

2013-2014 Flu Season


Updated April 23, 2014

Flu shot recommendations have changed a lot over the years.

While we now have a universal flu vaccine recommendation, where everyone who is at least six months old is supposed to get a flu vaccine each year, just 11 years ago, in 2001, flu vaccines were only targeted to children and adults in high-risk groups. Continued changes to the flu vaccine recommendations continued over the years, including:

  • encouraging vaccination of healthy children between the ages of 6 and 23 months when feasible for the 2002-03 flu season
  • that vaccination of healthy children between 6 and 23 months became a formal recommendation for the 2004-05 flu season
  • that vaccination of healthy children between 24 and 59 months became a formal recommendation for the 2006-07 flu season
  • that vaccination of healthy children between 5 and 18 years became a formal recommendation for the 2008-09 flu season
  • recommending universal flu vaccination for everyone who is at least 6 months old beginning with the 2010-11 flu season (adds people between the ages of 19 and 49 years)

Flu Shots - Latest Recommendations

There aren't any big changes in this year's recommendations for flu vaccines. Experts still recommended that everyone who is at least six months old get an a flu vaccine each year as soon as they can and before flu season begins.

The biggest change this year is really the availability of more flu vaccine options, including the quadrivalent flu vaccines (provide protection against four flu virus strains vs. the three strains that trivalent flu vaccines now protect us against) and an egg-free flu shot for people who are at least 18-years-old.

Although children who are younger than 9 years old still need two doses of the flu vaccine during the first year that they are vaccinated, a new recommendation last year clarifies other situations when they might also need two doses, especially if they haven't received two doses of seasonal flu vaccine since July 1, 2010.

Last year's recommendations also clarified rules for children with egg allergies, including that it is okay to get a flu shot if your child can eat lightly cooked eggs or only gets hives after eating eggs, although he should be observed for 30 minutes after getting his flu shot in case he does have an allergic reaction.

Lastly, last year's recommendations discussed a small risk of febrile seizures in children less than 4 years of age, especially if they also received the Prevnar 13 vaccine at the same time.

Flu Shots - When Should You Get It?

In the past few years, because of the shortages and delays, you didn't have much choice over when you could get your kids vaccinated. Most parents simply tried to get their kids vaccinated whenever they could.

When there's a ready supply of flu vaccine, as there is this season, you'll want to get your child vaccinated before flu season starts or as early as possible during flu season. You could get your flu vaccine at any time, but the longer you wait, the greater the risk that your child will catch the flu before he is protected by his flu vaccine. Keep in mind that a typical flu season usually begins in December, peaks in February, and may continue until March.

Pediatricians used to begin giving flu vaccine, if they had it, by mid-October and would hopefully finish vaccinating the majority of their patients by December. Most pediatricians and other clinics have already started giving flu shots this year though. The latest recommendations are that doctors start giving flu vaccine as soon as it is available.

Flu Shots - Who Needs One?

Remember, the latest recommendations are that everyone should get a flu vaccine.

So clearly, all children between the ages of 6 months and 18 years should get a flu vaccine each year, but that is especially important for high-risk groups, including:

  • children age 6 to 59 months
  • pregnant women and women who will be pregnant during flu season (usually October to March)
  • adults age 50 years and older
  • children and adults with most chronic health conditions, including asthma, diabetes, neurological and neuromuscular disorders (cerebral palsy, seizures, muscular dystrophy, etc.), and immune system problems
  • children and teens who are taking aspirin because of the risk of Reye syndrome
  • residents of long-term care facilities
  • household contacts and out-of-home caregivers of children younger than 6 months, or in other high-risk groups above
  • healthcare personnel who provide direct patient care

Keep in mind that the 'household contacts' part places a lot of extra kids into a high-risk group who should get a flu vaccine. For example, if you have a 3-year-old and a 10-year-old, they should both get a flu vaccine. Or, if one child in your family has asthma, everyone in your house should get a flu vaccine. The child with asthma is in a high-risk group, and everyone else is a household contact.

Remember that even if your child is not in a high-risk group, he can still get a flu vaccine if you want to simply reduce his risk of getting the flu this year.

And with the latest flu shot recommendations, experts now advise flu vaccines for everyone, including healthy adults between the ages of 18 and 49, so basically everyone over the age of 6 months should get a flu vaccine each year.

Flu Shots - Other Recommendations

  • Healthy people who are 2 to 49 years of age and not pregnant -- including health-care workers (except those who care for severely immunocompromised patients in special care units and persons caring for children younger than 6 months) -- can be vaccinated with Flumist, the nasal spray flu vaccine.
  • People should not get a flu vaccine if they have a severe allergy to chicken eggs; have had a severe reaction to an influenza vaccination in the past; have developed Guillain-Barre syndrome within 6 weeks of getting an influenza vaccine; if they are less than 6 months old; or if they have a moderate or severe illness with a fever.

One thing to keep in mind is that although thimerosal has been removed from all routinely recommended childhood vaccines, multi-dose vials of the flu vaccine does still contain thimerosal. This is not necessarily a reason to not get your child immunized, though, especially if he is in a high-risk group. A thimerosal-free flu vaccine is available for the 2013-2014 influenza season, although according to the CDC, 'the benefit of influenza vaccine with reduced or standard thimerosal content outweighs the theoretical risk, if any, from thimerosal.'

Updated for the 2013-2014 Flu Season.

For more information, please visit our guide to Kids and the Flu.



CDC. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices – United States, 2013-14, MMWR 2013, September 20, 2013 / 62(RR07);1-43

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